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DSH410011 Landmark Medical Center (Active)
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Main Details
Name
Landmark Medical Center
Subdivision Name
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH410011
Medicare Provider Number
410011
Additional Details
Current Program Status
Active
Registration Date
7/13/2018
Participating Start Date
10/1/2018
Participating Approval Date
8/3/2018
Last Recertification Date
8/16/2024
Contacts
Authorizing Official
Landmark Medical Center
scott brown, cfo
(401) 769-4100 Ext: 6601
Primary Contact
Landmark Medical Center
Kwun Heun Brian Leung, Director of Pharmacy
(401) 769-4100 Ext: 2466
Addresses
Street Address
115 Cass ave
Woonsocket, RI 02895
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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Participating 4/1/2013 until terminated effective 7/1/2013; reinstated effective 10/1/2018
07/16/2018
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